Analysis of Dentoalveolar and Maxillofacial Fractures with Multidetector-Row Computed Tomography

Yoshihiro Sugawara,Fumi Mizuhashi,Hirokazu Sekiguchi,Ichiro Ogura,Makoto Oohashi,Hisato Saegusa

doi:10.11648/j.ijmi.20190702.12

Abstract

Dentoalveolar trauma may occur after accidental falls, automotive accidents, violence, or contact sport injuries. This study aimed to investigate the prevalence of dentoalveolar and maxillofacial fractures with multidetector-row computed tomography (MDCT). Forty patients with dentoalveolar and maxillofacial fractures underwent MDCT. Mandibular fractures were classified into four types: median, paramedian, angle and condylar types. Midface fractures were classified into four types: Le Fort I-III and zygomatic maxillary complex types. Statistical analysis of the relationship between prevalence of dentoalveolar fractures and maxillofacial fracture locations was performed using Chi-square test with Fisher's exact test. A p-value less than 0.05 was considered statistically significant. The prevalence of dentoalveolar fractures was 15.0% (6/40 cases) of all patients with maxillofacial fractures. The mean age of patients with and without dentoalveolar fractures in maxillofacial fractures were 39.8 years and 54.7 years, respectively. Regarding cause of injury, the prevalence of maxillofacial fractures with dentoalveolar fractures were 18.8% of accidental falls and 0% of contact sport injuries and automotive accidents. There was no significant relationship between prevalence of dentoalveolar and maxillofacial fractures. The results suggest that the prevalence of dentoalveolar and maxillofacial fractures are related to the age and cause of injury.

Highlights

Dentoalveolar trauma may occur after accidental falls, automotive accidents, violence, contact sport injuries or accidents associated with the use of wheeled devices such as bicycles, skateboards, scooters or roller skates, both in children and adults [1,2]
The prevalence of maxillofacial fractures with dentoalveolar fractures were 18.8% of accidental falls and 0% of contact sport injuries and automotive accidents
Kobayashi-Velasco et al [3] showed that periapical radiograph showed poorer results than cone-beam computed tomography (CBCT) for the diagnosis of alveolar fractures

Summary

Introduction

Dentoalveolar trauma may occur after accidental falls, automotive accidents, violence, contact sport injuries or accidents associated with the use of wheeled devices such as bicycles, skateboards, scooters or roller skates, both in children and adults [1,2]. Trauma may results in tooth fracture and/or alveolar process injury. When the dental fracture happens in the crown, it is clinically diagnosed and the periapical radiograph is used to evaluate its extension and proximity to the pulp [3]. In cases of root fracture, periapical radiograph or cone-beam computed tomography (CBCT) images may be used to confirm the fracture and observe the tooth and adjacent alveolar bone. Radiographic evaluation is an indispensable tool for diagnosing fractures and traumatic injuries to the maxillofacial complex [4]. Multidetector-row computed tomography (MDCT) offers superior soft tissue characterization and is useful for diagnosis of odontogenic and nonodontogenic cysts and tumors, fibro-osseous lesions, inflammatory, malignancy, metastatic lesions, developmental abnormalities, and maxillofacial trauma [5]. Fracture morphology of maxillofacial trauma is often complex, so the clinicians should be familiar with the imaging findings [6].

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